Hybrid Technique for Question Mark Ear Treatment

The question mark ear is a rare external auricular deformity characterized by the cleft between the helix and earlobe. There is also limited guidance on the management of these deformities. A noteworthy aspect of the question mark ear is the broadening of the upper auricle, yet this feature can be easily overlooked. The hybrid technique, consisting of antihelix reformation, scapha reduction, and helical rim flap advancement, was proposed to correct the deformity and restore the natural appearance of the auricle. Auricular measurements, including the length and width of the auricle, the lateral circumference of the helix rim from the superior apex to the inferior apex, and the height of the cleft, were performed preoperatively and postoperatively. Fourteen patients with question mark ear deformities were treated, 11 unilaterally and 3 bilaterally. The patient’s ages ranged from 5 to 23 years old and 14.3 years on average. Follow-up ranged from 4 to 24 months and 10 months on average. Preoperative measurements indicated that the auricular width of the question mark ear was greater than that of the contralateral side, while postoperative measurements showed no significant difference in auricular width compared to the contralateral side. In addition, auricular measurements demonstrated a notable enhancement in the overall auricular configuration and cleft repair. The hybrid technique was applicable to correct question mark deformities with good results. The vertical mattress suture technique could reform the natural appearance of the antihelix. Scapha reduction and helical rim flap advancement were effective in correcting the cleft between the helix and earlobe.